Individual
ALLISON BALLANTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILA - GENERAL PEDIATRICS, PHILADELPHIA, PA 19104-4319
(215) 590-2164
(215) 590-2180
Mailing address
100 E PENN SQ, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9232
(267) 425-9299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD071541L
PA
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
MD071541L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001876052
—
PA
05
—
8719900
—
NJ
Enumeration date
07/19/2006
Last updated
04/18/2013
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